This research focuses on variations in relationships on physician-nurse practitioner teams with the goal of understanding 1) how the team relationship impacts upon productivity and patient and provider satisfaction, and 2) what factors determine the form that a particular relationship will take. Variations in team relationships are divided into two categories. One category concerns aspects of the team's work style. For example, is the team organized hierarchically, with the MD maintaining a supervisory and evaluative orientation toward the NP, or is it organized collegially with peer-like relationships between the two providers? Do the MD and NP perform the same kinds of clinical tasks or do they tend to specialize in different tasks? Do both providers care for the same patients, or do they split patients into two groups with each provider working more or less independently? The second category of variation includes the providers' attitudes toward their work style (i.e., whether they agree or disagree about the goals of their practice and their respective roles) and consequences those attitudes may have for the way they communicate and the way they regard each other. A model is proposed which hypothesizes that agreement between the MD and NP about the goals of their practice and their preferred work styles will be associated with high productivity, patient satisfaction and team satisfaction, and that the particular work style the team adopts will be a less important determinant of outcomes. Data will be collected on 30 MD-NP primary care teams at the Harvard Community Health Plan. The teams have been working together for an average of 3 years. Each team is responsible for the care of a particular panel of patients. Fifty patients per team will be sampled to assess their level of satisfaction with care. Administrative records will be used to determine level of team productivity. A provider questionnaire has been developed which measures the various aspects of team functioning. The questionnaire will be pretested and refined at an independent HMO as part of this project. The study will determine the strength of associations between key variables and will lead to further research in which causal hypotheses can be tested.